Provider Demographics
NPI:1922488162
Name:MEHAFFEY, MIA STANLEY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MIA
Middle Name:STANLEY
Last Name:MEHAFFEY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:MIA
Other - Middle Name:NOEL
Other - Last Name:STANLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:54 ALPINE WAY
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NC
Mailing Address - Zip Code:28721-5400
Mailing Address - Country:US
Mailing Address - Phone:828-421-1472
Mailing Address - Fax:828-631-1623
Practice Address - Street 1:380 BREVARD RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-2945
Practice Address - Country:US
Practice Address - Phone:828-253-4437
Practice Address - Fax:828-255-8635
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9929235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist